BMJ  2006;332:922 (15 April), doi:10.1136/bmj.332.7546.922

Minerva

Minerva

Minerva was about to dye her grey hair, but, after reading that hair colourants can cause hair loss (Medical Hypotheses 2006;66: 1048-9[ISI][Medline]), she's reconsidering. An observer of scalp hair loss in women says he's noticed it more among women who use dyes that contain hydrogen peroxide, amines, and phenols. When mixed, these cause oxidation and coupling, producing free radicals, which are cytotoxic to hair cells in animal models.

"Feeling worthless in the eyes of the other lies at the root of rage and violent revenge" (Medicine, Conflict and Survival 2006;22: 13-25[CrossRef]). The writer is discussing terrorism, explaining how terror breeds terrorists and why the current "War on Terror" can lead only to more terrorism. But the comments might equally apply to warring couples heading for the divorce courts.

Researchers have recently reaffirmed that exposure to sun, chronic smoking, and low body mass index are all associated with accelerated facial ageing. A Danish twin study also found that high social status, low depression score, and marriage are correlated with younger looks, although not surprisingly the strength of these associations varies between the sexes (Age and Ageing 2006;35: 110-5[Abstract/Free Full Text]).

"Throwing money at the problem only allows us to do more of what we have always done. Any suggestion of real reform has been a deceit: working patterns, practice and customs are at the heart of many capacity issues and have never been challenged," writes Aidan Halligan, director of clinical governance for the NHS (British Journal of Health Care Management 2006;12: 105-16). He is responding to the current state of England's NHS: midway through major reforms and in financial crisis. The journal itself reminds us that its previous issue called for the departure of the NHS chief executive Sir Nigel Crisp—who now indeed has gone.

Are girls more likely to develop adolescent respiratory symptoms than boys? A recent study (part of the large scale Norwegian Young-HUNT study) found that girls reported more wheeze and asthma than boys, and seemed more susceptible to risk factors such as environmental smoking and obesity. The study also suggests that girls whose mothers have asthma are more likely to have asthma diagnosed themselves (Respiratory Medicine 2006;100: 471-6[CrossRef][ISI][Medline]).

Minerva understands that her intelligence may be related to the physical dimensions of her brain. Researchers have found that young children with a thinner cortex that subsequently thickens during later childhood tend to have higher IQs than those who've had a thick cortex since early childhood. The most intelligent children have a particularly plastic cortex, with an initial phase of cortical increase followed by equally vigorous cortical thinning during late adolescence (Nature 2006;440: 676-8[CrossRef][Medline]).

One of the results of offering routine HIV testing to pregnant women in three London hospitals is that it has made HIV testing acceptable, and the uptake of the test is high. Another, less predictable, result is that women are now questioning the desirability of other antenatal tests that were previously routinely offered, with more women now refusing tests such as those for rubella, syphilis, and Down's syndrome (AIDS Care 2006;18: 183-8).

Weekly religious attendance is almost as effective as taking statins or regular physical exercise in improving life expectancy, according to an analysis of life expectancy tables (Journal of the American Board of Family Medicine 2006;19: 103-9). All three seem to account for an additional two to five years of life. But the practical significance of this finding remains controversial, and the authors warn that religious attendance is not a substitute for regular medical care.

Europe Direct, the European Union's free telephone service (00800 6 7 8 9 10 11), received more than 112 000 queries in 2005. Several hundred questions each month relate to health consumer protection and food safety issues. Many callers asked about food labelling, product testing, and standards with respect to food additives. But it's not just human health that the public is concerned about; callers also ask about animal welfare and the EU requirements for animals and pets to avoid pain and suffering.

Although screening can be bad for our health, it's interesting that a prospective study of women undergoing screening mammography found that a substantial fraction would prefer the inconvenience and anxiety associated with a higher rate of recall if it increased the chance of earlier detection of breast cancer. This US survey questioned more than 1500 women over one year (Radiology 2006;238: 793-800[Abstract/Free Full Text]).

Laboratory and animal studies indicate that cinnamon produces a strong insulin-like or insulin-potentiating effect. But a trial of dietary supplementation with cinnamon in postmenopausal women with type 2 diabetes failed to replicate these findings. Neither glycaemic control nor lipid profiles improved after a six week intervention (Journal of Nutrition 2006;136: 977-80[Abstract/Free Full Text]).

View larger version (117K): [in this window] [in a new window]   A 30 year old woman acquired a stepping machine for Christmas. As her New Year resolution, she used it every day in a bid to lose weight. She presented with bilateral knee pain but denied any direct trauma. Examination revealed palpable defects in both patellas. X rays showed bilateral bipartite patellas. This congenital variant is found in 1% of the population, and pain marks 2% of cases. Symptomatic patients tend to be those who perform repetitive knee flexion-extension, including joggers and those who repetitively scale flights of stairs. Management is usually supportive, with analgesia and rest. X rays may easily be misinterpreted by the unwary as showing a fractured patella. Anthony Parsons, pre-registration house officer, Nandan Kamat, senior house officer, Chika Uzoigwe, senior house officer (chika{at}doctors.co.uk), Edward Mills, specialist registrar, department of orthopaedics, Airedale General Hospitals, Keighley BD20 6TD

Blood pressure fluctuates during a 24 hour period, but whether this depends on physical activity alone remains unclear. In order to assess whether the blood pressure response to a given level of physical activity changes during a normal sleep-wake cycle, hypertensive patients underwent simultaneous 24 hour ambulatory blood pressure monitoring. Systolic pressure was more responsive than diastolic pressure, and responsiveness was greatest in the morning, with a secondary rise in the early afternoon (Hypertension 2006;47: 778-84[Abstract/Free Full Text]).

Doctors might want to prepare themselves for an onslaught of unsavoury tales, if Amanda of the consumer magazine Top Sante gets lucky. She's put out a recent call for "really strong, scandalous health-related stories such as `I fell in love with my GP,' `my GP tried to kill/rape me,' `I was abused by my hypnotherapist,' or `my therapist stole my husband.'" Amanda needs anything along these lines as she is "likely to be doing this on an ongoing basis."

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Rapid Responses:

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What's the plural of patella?

Jon D Clarke
bmj.com, 18 Apr 2006 [Full text]

Re: The pedants' curse

Theo Fenton
bmj.com, 19 Apr 2006 [Full text]

Re: Re: The pedants' curse

David Carvel
bmj.com, 20 Apr 2006 [Full text]